Provider Demographics
NPI:1003966342
Name:KURKER, RAYMOND CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CHARLES
Last Name:KURKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 OAKLAND RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2834
Mailing Address - Country:US
Mailing Address - Phone:860-644-5628
Mailing Address - Fax:860-648-1107
Practice Address - Street 1:25 OAKLAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2834
Practice Address - Country:US
Practice Address - Phone:860-644-5628
Practice Address - Fax:860-648-1107
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT027432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine